Digital Commons Network^™

Reducing Mortality From Severe Sepsis And Septic Shock: A Macro System Approach, Scott D. Baker

Doctor of Nursing Practice (DNP) Projects

Healthcare organizations must be able to provide quality patient care from arrival to disposition that is both expedient and safe. The Agency for Healthcare Research and Quality ranks septicemia as the number one most expensive condition treated in U.S. hospitals, resulting in aggregate costs of $20.3 billion or 5.2% of the total aggregate cost for all hospitalizations. Starting October 2015, the Centers for Medicare & Medicaid Services began tying financial reimbursement to improvement of sepsis outcomes. For success to be achieved, organizations should partner with prehospital providers to improve sepsis care, similar to partnerships which have historically improved acute myocardial …

Using Multi-Modal Education In A Public Health System To Increase Rates Of Cervical Cancer Screening, Christina Nardi

Doctor of Nursing Practice (DNP) Projects

While Papanicolaou (Pap) screening has been implemented since the 1950’s, and is linked to decreased rates of cervical cancer, national screening rates are still below the national target screening rate. In Contra Costa County (CCC), the current cervical cancer screening rate is 50.92% (Contra Costa Health Services [CCHS], 2016a). This is far below the national goal of 93% and the first benchmark of 54.33% needed in order to receive state funding under the California Department of Health Care Services (DHCS) Medi-Cal 2020 waiver. The Medi-Cal 2020 waiver has a 5-year Public Health Incentives and Redesign in Medi-Cal (PRIME) program requiring …

Optimizing Engagement In The Acute Care Setting: A Nurse Driven Staffing Model, Denise D. Fall

Doctor of Nursing Practice (DNP) Projects

Health care is on the threshold of major reform. Central to this reform will be the ability to maximize patient outcomes and resource allocation. The delivery of nursing care is essential to these concepts. Nursing care delivery impacts both patient outcomes and labor costs. Every aspect of care delivery has changed over time: length of stay, acuity, payment methodologies, documentation, technology, and regulatory requirements. Yet the model by which we allocate resources to the bedside is based on an archaic notion and forecasting model around one variable. The development of effective nurse staffing strategies will ensure those delivering care are …

Improving Employee Engagement Through The Development Of An Enterprise Performance Management System, Carlton D. Abner

Doctor of Nursing Practice (DNP) Projects

There is ample evidence of our health care delivery system relying heavily on value-based outcomes. The increased focus on outcomes has required health care organizations to adjust how they approach data and how they successfully implement performance management systems. These performance management systems help the organization identify, measure, and report the organization’s performance at an enterprise level using key performance indicators clearly linked to the organization’s overall strategy. As one organization began implementing an enterprise performance management system, the goal of this project was to show how participating in projects with that level of strategic impact can lead to improved …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Developing An Electronic Health Record Training Program For New Employees, Crystal D. Figlietti

Doctor of Nursing Practice (DNP) Projects

In May 2015, an electronic health record (EHR) was implemented at an urban, long-term care facility. This facility is part of the county Department of Public Health (DPH) and was one of the last locations to implement the designated EHR system. The unique nature of the facility compared to the smaller, health care centers within the DPH network necessitated development of a customized training and onboarding program for new employees. It was not possible to duplicate an existing training program. The registered nurse (RN) informaticist assigned to the EHR used data from nursing staff surveys and information collected through a …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

Innovative Techniques For Inspiring Efl Students' Enthusiasm And Participating In English Classroom Activities, Yinghung Natalie Chiang

Master's Projects and Capstones

Since 1990, the government of Taiwan has sought to position the country as an international economic and trading center. As a result, English became a compulsory subject for Taiwanese students in 2005 (Lu, 2011). The Taiwan Ministry of Education (MOE) is promoting communicative language teaching (CLT) and encouraging learners to develop and increased desire to improve their language skills. However, many Taiwanese English as Foreign Language (EFL) teachers still focus on memorization and the grammar translation method (Chung & Huang, 2009). The author discovered two major issues related to English language teaching in Taiwan. The first issue was many Taiwanese …

Discharge Prospectus, Cynthia Y. Vasquez

Master's Projects and Capstones

Background and Purpose:

The goals of the project are to improve the efficiency of the discharge process, to increase bed availability, to decrease readmission rates, and to increase patient satisfaction through implementation of multidisciplinary huddles.

Methods:

The intervention of the huddle took place on a medical-surgical unit at UC Davis Medical Center in the local Sacramento area serving various Medical Services.

This was a prospective pre- and post-quality intervention by utilizing HCAPHS survey, electronic medical record, RN surveys, and discharge data collection.

Results:

Discharges were increased from 15% to 23%. Currently, data is up-to-date for nine months but the project …

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …

Standardization Of Body Imaging Huddle In Radiology, Margaret M. Browne Mcmanus

Master's Projects and Capstones

Mag Browne McManus

Clinical Nurse Leader Abstract

University of San Francisco

Abstract

Communication amongst healthcare providers is critical to reducing errors, and in procedural areas, the huddle can be used to standardized communication amongst the team before the beginning of interventional procedures (Goldenhar, Brady, Sutcliffe, Muething, & Anderson, 2013). Prior to the implementation of the revised huddle, a staff survey indicated none of the staff were satisfied with the current process. The objectives of the standardization of the body imaging huddle in the department of radiology were to increase staff satisfaction by 15% and reduce the time from patient arrival …

Educating Nurses On The Use Of Bedside Mobility Assessment Tool (Bmat) Through E-Learning/Online Education Module, Wei Li Lee

Master's Projects and Capstones

Background Hospital setting is reviewed the most hazardous workplace comparing to other industries. Nursing assistants and orderlies have the high risk of work-related injury. The study found that the top reason that causes the injuries was due to over-exertion or bodily reaction.

Aim State of California requires hospitals to implement a Safe Patient Handling and Mobility (SPHM) policy as part of an injury and illness prevention program (Department of Industrial Regulations, 2016). Bedside Mobility Assessment Tool (BMAT) is the latest evidence based practice, reliable and valid tool, which helps nurses to assess the patients’ current and ongoing mobility and to …

Improving Cal Nagpra: Honoring Native American Rights, Kim Turner

Master's Projects and Capstones

The California Native American Graves Protection and Repatriation Act (Cal NAGPRA) became state law in 2001. Its purpose was to create a process whereby California tribes could seek to repatriate human remains and objects from their cultural heritage from museums and custodial institutions. Cal NAGPRA includes a number of shortcomings that have impeded the ability of tribes to successfully reclaim objects from their heritage. The ethical implications of museums retaining cultural objects and human remains, often confiscated from Native peoples or their tribal lands, has been a principal social justice topic of USF’s museum studies program. This capstone describes a …

Improving Pain Reassessment Within One Hour Following The Administration Of Pain Medication, Linda N. Baffoe-Twum

Master's Projects and Capstones

Abstract

Pain has been identified as the main reason why patients go to the hospital and are hospitalized. Pain reassessment following administration of pain medication is vital to pain management. This project was conducted in a 24-bed stand-alone inpatient psychiatric facility in an urban area. It was found that pain reassessment in this facility was not consistent with the facility policy and the Joint Commission standard. The patient population in the facility is made up of adults of 18 years and above, with mental health diagnosis such as depression, bipolar disorder, schizophrenia, anxiety, et cetera. Some of the patients also …

Humanistic Approach Vs. Technological Approach: Accelerate Language Learning By Having Fun In The Sun, Alex M. Lopez

Master's Projects and Capstones

Technology continues to spread throughout the world, and it seems that this trend will continue for some time. Many students have been left behind because the focus has been largely on viewing computer screens and communicating without the use of a voice, through text messages and chatting.

This project is based on the humanistic approach, and it is designed to promote activities that involve group work, taking the students outside of the classroom, and building a familial support system within the classroom by promoting class chemistry.

The project outlines activities that involve more communication and collaborative activities because these enable …

The Immigrants In The Central Coast Of California Need Motivation To Attend Classes And Learn English As Their Second Language, Martin Rodriguez-Juarez

Master's Projects and Capstones

This field project shows that the immigrant community that works in the fields from the Central Coast of California need the motivation to attend adult school to learn English as their second language. A six-week courses is included.

Critical Pedagogy And Peace Education In International Service-Learning: A Curriculum Exploring Race, Positionality, Power, And Privilege, Lissette A. Lizárraga

Master's Projects and Capstones

My project is an international service-learning curriculum intended to address the neocolonial implications that are perpetuated when sending predominately white, affluent participants abroad. My curriculum unpacks whiteness, privilege, the white savior complex, and American immigration history. Using race, power, and privilege, I explore how these themes relate to acquiring awareness and understanding of participants' societal positioning. Through this lens, my aim is that students can become aware of how systemic oppression works to disenfranchise certain groups, while others remain in power. With this awareness, students can become more mindful, aware, conscious, and critically engaged with their host communities through an …

Admission Handoff Between Emergency Department And Inpatient Units, Amanda A. Briones

Master's Projects and Capstones

When admitting a patient from the emergency department (ED) to an inpatient unit, a handoff report is conducted. There are many ways the ED nurse can go about delivering this report to the inpatient or floor nurse. Each ED nurse tends to this task in their own way, providing the information they deem important. Due to the absence of standardization, handoff reports have the ability to lack important information regarding the patient and can even lead to compromising the safety of the patient.

The purpose of this project was to gain a comprehensive understanding of the current handover process of …

Taking Matters Into Our Own Hands: Advocating For Advanced Language Learning In Mainstream Classrooms Through A ‘Multi-Cultural Capital’ Curriculum, Jill N. Radwanski

Master's Projects and Capstones

The purpose of this project is to supply teachers with curriculum for targeted advanced language learning skills, particularly in writing. It is also to acknowledge that despite the language status of the advanced student, language development should be seen more as a continuum and should continue well after a student is labeled ‘proficient.’

With careful consideration, both units include language lesson targeted for advanced language learners, acknowledge various perspective on a particular subject, are Common Core aligned, and allow for deep student reflection.

Accessibility And Technology: Remote Access To Art Through Telepresence Robotics, Jenna M. Hebert

Master's Projects and Capstones

This capstone project details a proposal for a remote tour pilot program and community partnership written for the Art Institute of Chicago, Snow City Arts and the John H Stroger, Jr. Hospital of Cook County. The proposal seeks to provide a model for remote accessibility to art museums for visitors with mobility disabilities. The pilot program utilizes telepresence technology as a tool for providing remote tours and for emulating the social benefits of a museum visit. Within the program, telepresence technology becomes a mechanism for communication and collaboration between the museum and members of the community, allowing individuals previously unable …

Hidden Museum: A Behind-The-Scenes Tour For Contemporary Audiences, Michael B. Glazier

Master's Projects and Capstones

The mystery of what lies behind a museum’s closed doors has intrigued visitors and perpetuated museum mythology for decades. Whether it’s peeking into collections storage, or being guided through rooms off the exhibition floor, visitors want unique access to museum collections. This Master’s Capstone project investigates the topic of behind-the-scenes tours within museums, asks what they look like today, and how they will develop in the future. Using this research I have created a project proposal to film a behind-the-scenes tour that will solve questions of public visibility and collection access for a San Francisco area history museum. A successful …

Making Museums Fashion Forward And Forward Thinking: A Proposal For A Rotating Exhibit Program At The Levi Strauss & Co. Museum, Hannah Claire Somerville

Master's Projects and Capstones

This capstone project is a theoretical proposal for a rotating exhibit program that was developed for the Levi Strauss & Co. museum in San Francisco, California. It was conceived with the intent to help eradicate some of the stigmas associated with museum fashion exhibitions. This capstone explores the complicated history of the museum field’s relationship with fashion and analyzes some of the social justice issues that the fashion and textile industries face today. The project’s purpose is to demonstrate that museum fashion exhibitions are more than frivolous window displays in a museum setting and that they have the ability to …

Pharmacovigilance In Post-Marketing: Risk Assessment And Reporting Standards, Tiffany Jee

Master's Projects and Capstones

While there has been new targeted drug therapies released into the market over the recent years, pulmonary arterial hypertension (PAH) remains to be a rapidly progressive disease with poor prognosis. Over time the arteries stiffen and tighten subsequently leaving the heart to pump harder to try and provide enough blood to the body. The extra stress of the increased pumping leads to weakening and enlargement of the heart. The endothelin targeted therapy, Letairis (ambrisentan), is an oral tablet proven to improve quality of life in patients suffering from PAH, WHO Group I – functional class II and III by helping …

“Mexico, Public Policy And Obesity In A Global Context”, Daniela Carina Bermudez

Master's Theses

Mexico has one of the most obese populations in the world. A country known for its diversity of rich flavorful food is drowning in low nutritional food products. This thesis examines Mexico’s obesity epidemic within the larger global context of international economic trade policies, public policies and Mexico’s health policies. The key research questions are 1) why is there an obesity epidemic in Mexico? and 2) what remedies should Mexico implement to control it? This thesis contributes to a viable policy strategy for the Mexican government to control and prevent the further increase of this obesity epidemic. Reviewing both the …

Assessing The Effectiveness Of Micro-Level Poverty Interventions In The Highlands Of Guatemala, Jacqueline A. Castro

Master's Theses

Despite immense efforts of poverty alleviation in the Western highlands of Guatemala, poverty is intense and widespread. Amidst an abundant array of poverty interventions, existing evidence on those interventions are not sufficient. Highlighting basic knowledge regarding impact evaluations, this paper aims to determine the most effective poverty intervention for the Western highland areas of Guatemala. Focusing on impact evaluations, this paper reviews 17 Latin American interventions, paying close attention to what may be applicable to this region. Using only the highest quality data from Latin America, it is clear that cash transfers and graduation programs are the most impactful interventions …

Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr

Master's Projects and Capstones

Patient safety is one of the major concern of any healthcare provider during their patient’s hospital stay. This project addressed the steady trend of fall incidences compared to last fiscal years’ data of an average of 4 falls per month. This trend created urgency to envisioned a plan for solutions to prevent this circumstance from happening. This Clinical Nurse Leader led a project in creating a process in identifying all patients that are high risk to fall (HRTF) prior to their admittance or transfer to Medical Surgical/Intermediate Care Unit and throughout their hospital stay until they are discharged. In addition, …

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects and Capstones

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed …

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects and Capstones

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …